Low PSA Metatastic Prostate Cancer

Hi Ron. I'm sorry that the cancer has spread. I do not know if your case is unusual but I do know that doctors keep saying, lately, that the psa to detect cancer should be lowered from 4 to 2.5 (especially in younger men - I too am 55 years old). My psa was 4.6 at diagnosis and I also had an RP. My surgeon said that there was some cancer at the edges and in the capsule but so far my post op psa is down to 0.04. I'm sure if they knew that it had spread, before you had surgery, they would not have had you going for surgery. I will keep you in my prayers. God bless - Mike

Ron, Read your post and your question " how often does one find such advanced involvement at so low a PSA level? " My husband, now 54, was also diagnosed soley via rate of rise, and then subsequent biopsy, in May 2002, at the age of 52. His PSA at the time was 3.7, and like you, it was the rate of rise that caught the attention of his doc. He had a RP in August of 02.The post op pathology report came back with a Gleason 3+4 = 7, moderately aggressive. All margins were clear, all nodes were clear, no sign of mets, bone scan prior to surgery was negative. Because there appeared to be no involvement outside the prostate, the surgeon decided to do the nerve sparing technique. All PSAs have been zero since surgery, but his most recent PSA in January, came back 0.15, which indicates a recurrance ( 17 months post op). My understanding is, that if your Gleason score is 7+ the odds of microscopic mets increases significantly, even if everything looks 'clear' at the time of surgery. My understanding as well, is that some of the more aggressive, poorly differentiated tumors do not produce PSA. We have an appointment in May with the surgeon and the oncologist. Apparently waiting until May will give them more information re: the doubling time, which will then help them make some suggestions re: treatment. They will also consider then, the possibility of a Prostascint Scan to check for bone mets. So, in response to your question, my understanding is, that anytime the Gleason score is 7+, the odds of microscopic (undetectable) mets, i.e. spread beyond the prostate, increases, even with a low level of PSA. You don't say what your Gleason score is, but your physician/oncologist will be able to tell you. Those higher Gleason scores are trickier to manage, but you are not alone. Based on hundreds of hours of reading that I have done, I seriously believe that diet, super nutrition, and exercise can make a difference in the rate of growth, even with more aggressive cancers. Lots of information, on the internet regarding this! Just go to a search engine and type in keywords: prostate cancer diet nutrition. Or, you can go to any online book vendor, and type in the same keywords, and pull up dozens of books now available on the subject. Hope this helps. Becky

Bhdon said:

Ron, Read your post and your question " how often does one find such advanced involvement at so low a PSA level? " My husband, now 54, was also diagnosed soley via rate of rise, and then subsequent biopsy, in May 2002, at the age of 52. His PSA at the time was 3.7, and like you, it was the rate of rise that caught the attention of his doc. He had a RP in August of 02.The post op pathology report came back with a Gleason 3+4 = 7, moderately aggressive. All margins were clear, all nodes were clear, no sign of mets, bone scan prior to surgery was negative. Because there appeared to be no involvement outside the prostate, the surgeon decided to do the nerve sparing technique. All PSAs have been zero since surgery, but his most recent PSA in January, came back 0.15, which indicates a recurrance ( 17 months post op). My understanding is, that if your Gleason score is 7+ the odds of microscopic mets increases significantly, even if everything looks 'clear' at the time of surgery. My understanding as well, is that some of the more aggressive, poorly differentiated tumors do not produce PSA. We have an appointment in May with the surgeon and the oncologist. Apparently waiting until May will give them more information re: the doubling time, which will then help them make some suggestions re: treatment. They will also consider then, the possibility of a Prostascint Scan to check for bone mets. So, in response to your question, my understanding is, that anytime the Gleason score is 7+, the odds of microscopic (undetectable) mets, i.e. spread beyond the prostate, increases, even with a low level of PSA. You don't say what your Gleason score is, but your physician/oncologist will be able to tell you. Those higher Gleason scores are trickier to manage, but you are not alone. Based on hundreds of hours of reading that I have done, I seriously believe that diet, super nutrition, and exercise can make a difference in the rate of growth, even with more aggressive cancers. Lots of information, on the internet regarding this! Just go to a search engine and type in keywords: prostate cancer diet nutrition. Or, you can go to any online book vendor, and type in the same keywords, and pull up dozens of books now available on the subject. Hope this helps. Becky

ProstaScint Scans
Hi Becky,
My second opinion Oncologist scheduled a ProstaScint scan. First group of Doctors suggested RP surgery, Casodex, radiation right away. The ProstaScint scan complimented my decision not to have Davinci RP surgery due to the Metastatic results found. I was surprised how many don't suggest ProstaScint scans for further detection. Please let me know if you have found any research regarding ProtaScints credibility. 56 at diagnosis with 14.7 PSA, 3+4=7, Gleason 7. Now I'm 58 with PSA 0.6 from intermittent lupron and Firmagon therapy.

Wishing you and yours good health.
Glen